tag:blogger.com,1999:blog-27356178.post4959024051985160128..comments2015-03-18T17:21:55.642+11:00Comments on villagemidwife: Understanding what's behind an adverse outcomeJoy Johnstonnoreply@blogger.comBlogger9125tag:blogger.com,1999:blog-27356178.post-43439220923194436392012-07-11T15:03:54.234+10:002012-07-11T15:03:54.234+10:00For those who are interested, here&#39;s a comment...For those who are interested, here&#39;s a comment by Rachel Zimmerman in CommonHealth that I recommend<br />http://commonhealth.wbur.org/2012/07/anti-home-birth-activistJoy Johnstonhttp://www.blogger.com/profile/16475164378153618715noreply@blogger.comtag:blogger.com,1999:blog-27356178.post-20838816312228738092012-06-20T07:35:15.392+10:002012-06-20T07:35:15.392+10:00Anonymous, you have asked a direct question to me,...Anonymous, you have asked a direct question to me, whether I inform inquirers that homebirth is &quot;now proven to be more dangerous than hospital birth in low risk primips&quot; <br />No. <br />My commitment is to the woman, not to the setting. <br />I would encourage you to reflect on your use of the word &#39;proven&#39;.Joy Johnstonhttp://www.blogger.com/profile/16475164378153618715noreply@blogger.comtag:blogger.com,1999:blog-27356178.post-32595704583097520752012-06-20T00:55:33.314+10:002012-06-20T00:55:33.314+10:00Interesting comments. No-one likes to see women up...Interesting comments. No-one likes to see women upset eg. separation from her baby (although there might have been a very good reason).<br /><br />I would blame you mainly for the PPH upset.<br /><br />a) You didn&#39;t prepare your patient properly for standard PPH prophylaxis / management.<br />b) By saying &quot;oh all that was really unnecessary&quot; to your patient, you&#39;ve reinforced her inappropriate feelings.<br /><br />Your inactions/actions have caused harm, not the hospital midwives. Reflect.<br /><br />Homebirth midwives are a dangerous breed generally. I do hope you tell your patients that homebirth is now proven to be more dangerous than hospital birth in low risk primips (Birthplace study) never mind breeches, VBACs etc. before taking their money. Do you?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-27356178.post-47110672473860103742012-06-12T09:35:44.349+10:002012-06-12T09:35:44.349+10:00Hello!
It&#39;s a frosty Monday morning here in Me...Hello!<br />It&#39;s a frosty Monday morning here in Melbourne. <br />Over the weekend I have reflected on whether there was really something exceptional about what I wrote; whether I should re-consider my attitude, having received such strong responses.<br />I have re-read the original post, and stand by it. The point of that example (IV cannula insitu) is to identify over-agressive, unnecessary treatment as a potential harm to be avoided. Iatrogenic illness cannot be ignored; in this case the postnatal recovery journey included a urinary tract infection and breast thrush, which may have been avoided. <br /><br />The comment I made about practising without restriction may have been misunderstood. I have no problem with boundaries, and midwifery is clearly defined. The particular restriction midwives face in Australia is that we are unable to have visiting access in hospitals. I will amend the post by adding (midwifery).Joy Johnstonhttp://www.blogger.com/profile/16475164378153618715noreply@blogger.comtag:blogger.com,1999:blog-27356178.post-32824664529213054722012-06-11T12:48:29.799+10:002012-06-11T12:48:29.799+10:00Ms. Johnston,
You seemed to have missed the point...Ms. Johnston,<br /><br />You seemed to have missed the point of my comment. It makes absolutely no difference whether the IV was needed or not. No IV, no matter how unpleasant, can EVER be considered equivalent to the loss of a human life.<br /><br />Australian homebirth midwives ARE more concerned about their personal income and status than the lives of the babies in their hands, and your extremely callous &quot;comparison&quot; of IVs and neonatal deaths is a perfect example of that.<br /><br />Exactly how many babies have to die before Australian homebirth midwives acknowledge that they are incapable of regulating themselves?Amy Tuteur, MDhttp://www.blogger.com/profile/08496583576036722794noreply@blogger.comtag:blogger.com,1999:blog-27356178.post-65083222389347632652012-06-11T12:46:22.078+10:002012-06-11T12:46:22.078+10:00Hi joy,
I think you completely miss the point. Hav...Hi joy,<br />I think you completely miss the point. Having midwives practice without restriction in any setting??? Seriously? I am an Ob, and I certainly wouldn&#39;t want to practice without restriction. That&#39;s a preposterous statement and illustrates your lack of understanding about this complex issue, despite your description of your extensive experience.<br /><br />Hospitals are not without their share of problems, but untrained midwives without the skills to diagnose and manage the complications are not going to solve those problems. How about real midwives, with real training and REGULATED hospital privileges, who can work with physicians as a TEAM to improve care. Or would that threaten you in some way? Avoiding hospitals and receiving substandard care at home isn&#39;t the answer for any woman who values the child she is carrying...Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-27356178.post-65673031698423795042012-06-11T10:29:31.479+10:002012-06-11T10:29:31.479+10:00Thankyou Dr Amy and &#39;kateg&#39; for responding...Thankyou Dr Amy and &#39;kateg&#39; for responding to this post. <br /><br />You have both questioned a case I referred to. The woman did NOT have a post partum haemorrhage - she merely had risk factors that may have increased her chance of PPH, and she had an IV cannula in situ.<br /><br />I do know the blood loss was minimal at the time, when aggressive treatment for PPH was initiated. I was there, and having been a midwife for almost 40 years I am confident in my clinical judgment. Of course I can&#39;t know it would not have been significant if some other course of action had been followed ...<br /><br />As we tidied up I spoke about the blood loss with the hospital midwife who had been responsible at the birth. She agreed that the blood loss was not excessive - I think the total loss recorded was 400ml.<br /><br /><br />As for the other comment, that Australian homebirth midwives should be ashamed that we are more concerned about our &quot;personal income and status than the lives of the babies in their hands&quot; - of course, if that were true, I would support it. But I don&#39;t know any of those. There is no secure income, and even less status in independent midwifery practice in this country.<br /><br />ps the tone of Dr Amy&#39;s post made me consider deleting it. I would appreciate respectful communication, even when you feel the need to challenge what I or someone else have written.Joy Johnstonhttp://www.blogger.com/profile/16475164378153618715noreply@blogger.comtag:blogger.com,1999:blog-27356178.post-70398354973103756152012-06-11T09:24:40.481+10:002012-06-11T09:24:40.481+10:00your patient actually complained about being treat...your patient actually complained about being treated for postpartum hemorrhage? seriously? how do you know the blood loss was not (would not have been significant)?kateghttp://www.blogger.com/profile/18192812672040930235noreply@blogger.comtag:blogger.com,1999:blog-27356178.post-51641666123975119252012-06-11T00:01:52.703+10:002012-06-11T00:01:52.703+10:00It hard to imagine anything more morally bankrupt ...It hard to imagine anything more morally bankrupt thaan equating a &quot;traumatic&quot; IV for postpartum hemorrhage to the entirely prevetnable deaths of 4 human beings.<br /><br />Australian homebirth midwives should be ashamed that they are more concerned about their personal income and status than the lives of the babies in their hands.Amy Tuteur, MDhttp://www.blogger.com/profile/08496583576036722794noreply@blogger.com